青光眼白内障联合术后超声生物显微镜下房角结构的观察

An observation of anterior chamber angle structure after combined glaucoma and cataract surgery by ultrasound biomicroscopy

目的探讨青光眼白内障联合手术对合并白内障的原发性闭角型青光眼(primaryangle-closureglaucoma,PACG)的房角及其相关结构的影响。方法对合并白内障的PACG患者30例(30只眼)行白内障囊外摘除人工晶状体植入联合小梁切除术,用超声生物显微镜(ultrasoundbiomicroscopy,UBM)分别于术前和术后1个月进行房角结构测量。结果中央前房深度(ACD)、房角开放距离500(AOD500)、小梁虹膜角(TIA)、小梁睫状体距离(TCPD)术前术后比较差异均有显著性(均P<0.05)。虹膜厚度1(ID1)术前术后比较差异无显著性(P>0.05)。结论青光眼白内障联合手术可明显加深前房,增宽房角,重新开放小梁网。这有助于更好地控制眼压,减少术后浅前房等并发症的发生。

OBJECTIVE To study the effect of combined glaucoma and cataract surgery on anterior chamber angle and its related structure in the patients with primary angle - closure glaucoma （PACG） .METHODS Combined extracapsular cataract extraction, intraocular lens （IOL） implantation and trabeculectomy were performed in 30 patients （30 eyes） with cataract and PACG. Their anterior chamber angle structure was separately determined by using uhrasound biomicroscopy （UBM） before and after surgery. RESULTS There were statistically significant differences between the preoperative and postoperative ACD, AOD500, TIA, TCPD（ PACD 〈 0.05; PAODCA500 〈 0.05; PTtA 〈 0.05; PTCPD 〈 0.05）. There was no statistically differences between the preoperative and postoperative IDI （P 〉 0.05） .CONCLUSIONS Combined glaucoma and cataract surgery could deepen the anterior chamber and anterior chamber angle, reopens trabecula. It contributes to control intraocular pressure better and reduce postoperative complications such as shallow anterior chamber.